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J Emerg Nurs. 2009 Jun;35(3):199-204; quiz 273-4. doi: 10.1016/j.jen.2008.05.003. Epub 2008 Jul 15.

Prevalence of secondary traumatic stress among emergency nurses.

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Inland Empire Chapter, Hemet Valley Medical Center, Hemet, CA, USA.



Emergency nurses often care for persons exposed to traumatic events. In the presence of empathetic caring, nurses exposed to such stressors over time can suffer from Secondary Traumatic Stress (STS), or Compassion Fatigue (CF). STS symptoms (intrusion, avoidance, and arousal) may lead to job dissatisfaction or burnout. The purpose of this study is to investigate the prevalence of STS in emergency nurses.


Exploratory comparative design, with 67 emergency nurses from three general community hospitals in California. Survey instruments included a demographic tool and the STS Survey (STSS).


Nurses were most likely to have Arousal symptoms (irritability reported by 54% of nurses), followed by Avoidance symptoms (avoidance of patients 52%), and Intrusion symptoms (intrusive thoughts about patients 46%). The majority of nurses (85%) reported at least one symptom in the past week. Utilizing Bride's algorithm to identify STS, 15% of nurses met no criteria, while 33% met all. Nurse participation in stress management activities was associated with less prevalence of STS symptoms.


High prevalence of STS in our sample indicates that potentially large numbers of emergency nurses may be experiencing the negative effects of STS. Symptoms may contribute to emotional exhaustion and job separation of emergency nurses. Subsequent studies should be done to evaluate the association of CF/STS on actual burnout and attrition among emergency nurses.

[Indexed for MEDLINE]

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